追踪评价超声诊断异位妊娠的准确率及其影响因素分析

Follow-up evaluation of the accuracy of ultrasound in the diagnosis of ectopic pregnancy and its influence factors

目的:分析超声诊断异位妊娠(ectopic pregnancy,EP)的准确率及其影响因素。方法:回顾性分析妇产科超声诊断为EP病人156例临床资料,追踪其手术病理结果,核对病人超声诊断与病理报告诊断的一致性,并分析影响超声诊断准确率的影响因素。结果:156例病人最终经病理证实125例,诊断准确率为80.13%。超声检查明确见到孕囊144例,初次超声检查未发现孕囊的不明位置妊娠病人12例。多因素logistic回归分析显示,有无盆腔炎症、是否检测血清人绒毛膜促性腺激素水平和停经时间均为超声诊断EP准确率的独立影响因素(P<0.01)。结论:EP的临床诊疗过程中应特别关注早期EP和盆腔炎病人,对于不能确诊的病人,可结合血清人绒毛膜促性腺激素水平和临床症状并做好病人随访,尽可能提高超声诊断EP的准确率。

Objective:To analyze the accuracy of ultrasound in the diagnosis of ectopic pregnancy and its influencing factors.Methods:The clinical data of 156 patients with ectopic pregnancy diagnosed by ultrasound were retrospectively analyzed.The results of surgical pathology were followed up to verify the consistency between the ultrasound diagnosis and pathological report diagnosis,and the factors influencing the accuracy of ultrasound diagnosis were analyzed.Results:Among 156 cases,125 patients were confirmed by pathology,and the diagnostic accuracy of which was 80.13%.The pregnancy sac in 144 cases were clearly detected using ultrasound,and the unknown location of pregnancy sac in 12 cases were not detected by initial ultrasound.The results of multivariate logistic regression analysis showed that the pelvic inflammation,serum human chorionic gonadotropin(HCG)and menopause time>6 weeks were the independent influencing factors of ultrasonic diagnosis accuracy of ectopic pregnancy(P<0.01).Conclusions:During the clinical diagnosis and treatment of ectopic pregnancy,the early ectopic pregnancy and pelvic inflammatory disease should be paid attention to.For undiagnosed patients,the accuracy of ultrasonic diagnosis of ectopic pregnancy can be improved as far as possible by combining serum human chorionic gonadotropin level,clinical symptoms and follow-up of patients.